Cost containment is not simply an economic issue. Its implementation is intricately hinged on adjustments in institutional relations at the community level. One of the most explosive community issues health planners and Health System Agencies will experience in the future will be health facility closures, conversions, or reductions in health services. Termination is the most difficult and volatile of management strategies because it goes against the forces for organizational and program self perpetuation. Termination may not only mean cuts in health services, but also may produce wide-ranging effects in the community at large, e.g., causing economic hardship for employees of health institutions and placing extra burdens on citizens seeking access to health care. This research is designed to advance knowledge of termination strategies and thus provide local and state health planners with a useful document, sensitive to such impacts, to assist their efforts to reduce excess and duplicative institutional health services. The research will review and synthesize what has been written on characteristics of alternative supply reduction strategies; the political economic and administrative consequences of attempting different strategies; and the appropriate role for state agencies and Health System Agencies in implementing or encouraging such strategies.